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Published on: September 11, 2012
CT appearance of disseminated peritoneal adenomucinosis
R E Bechtold1, M Y Chen, B W Loggie
1Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1088, USA.
Abstract:
Disseminated peritoneal adenomucinosis (DPAM) is a relatively rare cause of pseudomyxoma peritonei, marked by peritoneal lesions with abundant extracellular mucin and little cytologic atypia among exfoliated tumor cells, and usually associated with appendiceal adenomas. Peritoneal mucinous carcinomatosis (PMCA) also causes diffuse peritoneal tumor but is marked by neoplastic mucinous epithelium with cytologic features of carcinoma and associated with appendiceal, colon, gastric, or small bowel carcinoma. Compared with PMCA, DPAM has a different distribution of disease and a significantly better prognosis. DPAM is characterized by the lack of lymph node involvement, with primarily superficial peritoneal involvement, and a relatively benign, relapsing course over many years. Dominant primary masses may not be evident in DPAM. Despite considerable overlap in the two main causes of pseudomyxoma peritonei, there are features of the two that may help differentiate between them. We present the computed tomographic appearance of DPAM in a series of seven cases and emphasize characteristics of the disease.
Insights
Disseminated peritoneal adenomucinosis (DPAM) is a rare cause of pseudomyxoma peritonei, distinct from peritoneal mucinous carcinomatosis (PMCA). DPAM presents with superficial peritoneal involvement and a better prognosis, often lacking obvious primary masses.
Area of Science:
- Oncology
- Gastroenterology
- Radiology
Background:
- Disseminated peritoneal adenomucinosis (DPAM) is a rare condition causing pseudomyxoma peritonei, characterized by abundant extracellular mucin and minimal cytologic atypia.
- It is typically associated with appendiceal adenomas and differs from peritoneal mucinous carcinomatosis (PMCA), which involves neoplastic mucinous epithelium with carcinomatous features.
- DPAM has a more favorable prognosis, primarily superficial peritoneal involvement, and lacks lymph node metastasis.
Purpose of the Study:
- To describe the computed tomographic (CT) appearance of DPAM.
- To highlight key imaging characteristics that differentiate DPAM from PMCA.
- To enhance understanding of DPAM's distinct disease distribution and clinical course.
Main Methods:
- Retrospective review of seven cases diagnosed with DPAM.
- Analysis of computed tomographic (CT) scans to identify characteristic imaging features.
- Comparison of imaging findings with clinical and pathological data.
Main Results:
- DPAM demonstrates specific CT findings, including superficial peritoneal thickening and abundant mucin deposition.
- The distribution of disease in DPAM is predominantly superficial, contrasting with the deeper involvement often seen in PMCA.
- Lack of lymph node involvement and a generally benign, relapsing clinical course over many years were noted.
Conclusions:
- Computed tomography plays a crucial role in differentiating DPAM from PMCA based on characteristic imaging patterns.
- Understanding these imaging features aids in accurate diagnosis and management of pseudomyxoma peritonei.
- DPAM represents a distinct clinicopathological entity with a favorable prognosis compared to PMCA.
